RESUMEN
Polyomaviruses are species-specific DNA viruses that can cause disease in immunocompromised individuals. Despite their role as the causative agents for several diseases, there are no currently approved antivirals for treating polyomavirus infection. Brincidofovir (BCV) is an antiviral approved for the treatment of poxvirus infections and has shown activity against other double-stranded DNA viruses. In this study, we tested the efficacy of BCV against polyomavirus infection in vitro and in vivo using mouse polyomavirus (MuPyV). BCV inhibited virus production in primary mouse kidney cells and brain cortical cells. BCV treatment of cells transfected with MuPyV genomic DNA resulted in a reduction in virus levels, indicating that viral inhibition occurs post-entry. Although in vitro BCV treatment had a limited effect on viral DNA and RNA levels, drug treatment was associated with a reduction in viral protein, raising the possibility that BCV acts post-transcriptionally to inhibit MuPyV infection. In mice, BCV treatment was well tolerated, and prophylactic treatment resulted in a reduction in viral DNA levels and a potent suppression of infectious virus production in the kidney and brain. In mice with chronic polyomavirus infection, therapeutic administration of BCV decreased viremia and reduced infection in the kidney. These data demonstrate that BCV exerts antiviral activity against polyomavirus infection in vivo, supporting further investigation into the use of BCV to treat clinical polyomavirus infections. IMPORTANCE: Widespread in the human population and able to persist asymptomatically for the life of an individual, polyomavirus infections cause a significant disease burden in the immunocompromised. Individuals undergoing immune suppression, such as kidney transplant patients or those treated for autoimmune diseases, are particularly at high risk for polyomavirus-associated diseases. Because no antiviral agent exists for treating polyomavirus infections, management of polyomavirus-associated diseases typically involves reducing or discontinuing immunomodulatory therapy. This can be perilous due to the risk of transplant rejection and the potential development of adverse immune reactions. Thus, there is a pressing need for the development of antivirals targeting polyomaviruses. Here, we investigate the effects of brincidofovir, an FDA-approved antiviral, on polyomavirus infection in vivo using mouse polyomavirus. We show that the drug is well-tolerated in mice, reduces infectious viral titers, and limits viral pathology, indicating the potential of brincidofovir as an anti-polyomavirus therapeutic.
Asunto(s)
Antivirales , Citosina , Organofosfonatos , Infecciones por Polyomavirus , Poliomavirus , Animales , Citosina/análogos & derivados , Citosina/farmacología , Citosina/uso terapéutico , Infecciones por Polyomavirus/tratamiento farmacológico , Infecciones por Polyomavirus/virología , Poliomavirus/efectos de los fármacos , Ratones , Antivirales/farmacología , Antivirales/uso terapéutico , Organofosfonatos/farmacología , Organofosfonatos/uso terapéutico , Replicación Viral/efectos de los fármacos , Riñón/virología , Riñón/efectos de los fármacos , Femenino , ADN Viral/genética , Células Cultivadas , Modelos Animales de Enfermedad , Ratones Endogámicos C57BL , Encéfalo/virologíaRESUMEN
Integrating lipid conjugation strategies into the design of nucleoside monophosphate and monophosphonate prodrugs is a well-established approach for discovering potential therapeutics. The unique prodrug design endows nucleoside analogues with strong lipophilicity and structures resembling lysoglycerophospholipids, which improve cellular uptake, oral bioavailability and pharmacological activity. In addition, the metabolic stability, pharmacological activity, pharmacokinetic profiles and biodistribution of lipid prodrugs can be finely optimized by adding biostable caps, incorporating transporter-targeted groups, inserting stimulus-responsive bonds, adjusting chain lengths, and applying proper isosteric replacements. This review summarizes recent advances in the structural features and application fields of lipid-conjugated nucleoside monophosphate and monophosphonate prodrugs. This collection provides deep insights into the increasing repertoire of lipid prodrug development strategies and offers design inspirations for medicinal chemists for the development of novel chemotherapeutic agents.
Asunto(s)
Lípidos , Nucleósidos , Profármacos , Profármacos/química , Profármacos/farmacología , Profármacos/síntesis química , Humanos , Lípidos/química , Nucleósidos/química , Nucleósidos/farmacología , Nucleósidos/síntesis química , Animales , Sistemas de Liberación de Medicamentos , Antineoplásicos/química , Antineoplásicos/farmacología , Estructura Molecular , Organofosfonatos/química , Organofosfonatos/farmacologíaRESUMEN
The increasing importance of azaheterocyclic phosphonates in the agrochemical, synthetic, and medicinal field has provoked an intense search in the development of synthetic routes for obtaining novel members of this family of compounds. This updated review covers methodologies established since 2004, focusing on the synthesis of azaheterocyclic phosphonates, of which the phosphonate moiety is directly substituted onto to the azaheterocyclic structure. Emphasizing recent advances, this review classifies newly developed synthetic approaches according to the ring size and providing information on biological activities whenever available. Furthermore, this review summarizes information on various methods for the formation of C-P bonds, examining sustainable approaches such as the Michaelis-Arbuzov reaction, the Michaelis-Becker reaction, the Pudovik reaction, the Hirao coupling, and the Kabachnik-Fields reaction. After analyzing the biological activities and applications of azaheterocyclic phosphonates investigated in recent years, a predominant focus on the evaluation of these compounds as anticancer agents is evident. Furthermore, emerging applications underline the versatility and potential of these compounds, highlighting the need for continued research on synthetic methods to expand this interesting family.
Asunto(s)
Antineoplásicos , Compuestos Heterocíclicos , Organofosfonatos , Organofosfonatos/química , Organofosfonatos/síntesis química , Organofosfonatos/farmacología , Compuestos Heterocíclicos/química , Compuestos Heterocíclicos/síntesis química , Compuestos Heterocíclicos/farmacología , Humanos , Antineoplásicos/síntesis química , Antineoplásicos/farmacología , Antineoplásicos/química , Compuestos Aza/química , Compuestos Aza/síntesis química , Compuestos Aza/farmacología , AnimalesRESUMEN
A series of the first conjugates of N-acetyl-d-glucosamine with α-aminophosphonates was synthesized using the Kabachnik-Fields reaction, the Pudovik reaction, a copper(I)-catalyzed azide-alkyne cycloaddition reaction (CuAAC) and evaluated for the in vitro cytotoxicity against human cancer cell lines M - HeLa, HuTu-80, A549, PANC-1, MCF-7, T98G and normal lung fibroblast cells WI-38. The tested conjugates, with exception of compound 21b, considered as a lead compound, were either inactive against the used cancer cells or showed moderate cytotoxicity in the range of IC50 values 33-80 µM. The lead compound 21b, being non cytotoxic against normal human cells WI-38 (IC50 = 90 µM), demonstrated good activity (IC50 = 17 µM) against breast adenocarcinoma cells (MCF-7) which to be 1.5 times higher than the activity of the used reference anticancer drug tamoxifen (IC50 = 25.0 µM). A flexible receptor molecular docking simulation showed that the cytotoxicity of the synthesized conjugates of N-acetyl-d-glucosamine with α-aminophosphonates against breast adenocarcinoma MCF-7 cell line is due to their ability to inhibit EGFR kinase domain. In addition, it was found that conjugates 22a and 22b demonstrated antioxidant activity that was not typical for α-aminophosphonates.
Asunto(s)
Acetilglucosamina , Antineoplásicos , Antioxidantes , Simulación del Acoplamiento Molecular , Organofosfonatos , Humanos , Organofosfonatos/química , Organofosfonatos/farmacología , Organofosfonatos/síntesis química , Antineoplásicos/farmacología , Antineoplásicos/síntesis química , Antineoplásicos/química , Acetilglucosamina/química , Acetilglucosamina/farmacología , Antioxidantes/farmacología , Antioxidantes/síntesis química , Antioxidantes/química , Ensayos de Selección de Medicamentos Antitumorales , Relación Estructura-Actividad , Línea Celular Tumoral , Estructura Molecular , Proliferación Celular/efectos de los fármacosRESUMEN
An unprecedented study of the application of planar chiral compounds in antiviral pesticide development is reported. A class of multifunctional planar chiral ferrocene derivatives bearing α-amino phosphonate moieties was synthesized. These compounds, exhibiting superior optical purities, were subsequently subjected to antiviral evaluations against the notable plant pathogen potato virus Y (PVY). The influence of the absolute configurations of the planar chiral compounds on their antiviral bioactivities was significant. A number of these enantiomerically enriched planar chiral molecules demonstrated superior anti-PVY activities. Specifically, compound (Sp, R)-9n displayed extraordinary curative activities against PVY, with a 50% maximal effective concentration (EC50) of 216.11 µg/mL, surpassing the efficacy of ningnanmycin (NNM, 272.74 µg/mL). The protective activities of compound (Sp, R)-9n had an EC50 value of 152.78 µg/mL, which was better than that of NNM (413.22 µg/mL). The molecular docking and defense enzyme activity tests were carried out using the planar chiral molecules bearing different absolute configurations to investigate the mechanism of their antiviral activities against PVY. (Sp, R)-9n, (Sp, R)-9o, and NMM all showed stronger affinities to the PVY-CP than the (Rp, S)-9n. Investigations into the mechanisms revealed that the planar chiral configurations of the compounds played pivotal roles in the interactions between the PVY-CP molecules and could augment the activities of the defense enzymes. This study contributes substantial insights into the role of planar chirality in defending plants against viral infections.
Asunto(s)
Antivirales , Simulación del Acoplamiento Molecular , Organofosfonatos , Enfermedades de las Plantas , Potyvirus , Solanum tuberosum , Antivirales/farmacología , Antivirales/síntesis química , Antivirales/química , Enfermedades de las Plantas/virología , Organofosfonatos/farmacología , Organofosfonatos/química , Organofosfonatos/síntesis química , Solanum tuberosum/virología , Solanum tuberosum/química , Potyvirus/efectos de los fármacos , Relación Estructura-Actividad , Estereoisomerismo , Estructura MolecularRESUMEN
Mpox virus has wildly spread over 108 non-endemic regions in the world since May 2022. DNA replication of mpox is performed by DNA polymerase machinery F8-A22-E4, which is known as a great drug target. Brincidofovir and cidofovir are reported to have broad-spectrum antiviral activity against poxviruses, including mpox virus in animal models. However, the molecular mechanism is not understood. Here we report cryogenic electron microscopy structures of mpox viral F8-A22-E4 in complex with a DNA duplex, or dCTP and the DNA duplex, or cidofovir diphosphate and the DNA duplex at resolution of 3.22, 2.98 and 2.79 Å, respectively. Our structural work and DNA replication inhibition assays reveal that cidofovir diphosphate is located at the dCTP binding position with a different conformation to compete with dCTP to incorporate into the DNA and inhibit DNA synthesis. Conformation of both F8-A22-E4 and DNA is changed from the pre-dNTP binding state to DNA synthesizing state after dCTP or cidofovir diphosphate is bound, suggesting a coupling mechanism. This work provides the structural basis of DNA synthesis inhibition by brincidofovir and cidofovir, providing a rational strategy for new therapeutical development for mpox virus and other pox viruses.
Asunto(s)
Antivirales , Cidofovir , Citosina , Replicación del ADN , Organofosfonatos , Replicación Viral , Cidofovir/farmacología , Cidofovir/química , Organofosfonatos/farmacología , Organofosfonatos/química , Citosina/análogos & derivados , Citosina/farmacología , Citosina/química , Replicación del ADN/efectos de los fármacos , Humanos , Antivirales/farmacología , Antivirales/química , Replicación Viral/efectos de los fármacos , ADN Viral , Modelos MolecularesRESUMEN
Human adenoviruses can cause serious, disseminated infections in immunocompromised patients. For pediatric allogeneic stem cell transplant patients, the case fatality rate can reach 80%. Still, there is no available antiviral drug that is specifically approved by the Food and Drug Administration for the treatment of adenovirus infections. To fill this pressing medical need, we have developed NPP-669, a prodrug of cidofovir with broad activity against double-stranded DNA viruses, including adenoviruses. Here, we report on the in vivo anti-adenoviral efficacy of NPP-669. Using the immunosuppressed Syrian hamster as the model, we show that NPP-669 is highly efficacious when dosed orally at 1 mg/kg and 3 mg/kg. In a delayed administration experiment, NPP-669 was more effective than brincidofovir, a similar compound that reached Phase III clinical trials. Furthermore, parenteral administration of NPP-669 increased its efficacy approximately 10-fold compared to oral dosing without apparent toxicity, suggesting that this route may be preferable in a hospital setting. Based on these findings, we believe that NPP-669 is a promising new compound that needs to be further investigated.
Asunto(s)
Antivirales , Cidofovir , Citosina , Mesocricetus , Organofosfonatos , Profármacos , Animales , Antivirales/farmacología , Antivirales/uso terapéutico , Profármacos/farmacología , Profármacos/uso terapéutico , Humanos , Cidofovir/farmacología , Cidofovir/uso terapéutico , Organofosfonatos/farmacología , Organofosfonatos/uso terapéutico , Citosina/análogos & derivados , Citosina/farmacología , Citosina/uso terapéutico , Adenovirus Humanos/efectos de los fármacos , Infecciones por Adenovirus Humanos/tratamiento farmacológico , Infecciones por Adenovirus Humanos/virología , Modelos Animales de Enfermedad , Cricetinae , Administración OralRESUMEN
New acyclic pyrimidine nucleoside phosphonate prodrugs with a 4-(2,4-diaminopyrimidin-6-yl)oxy-but-2-enyl]phosphonic acid skeleton (O-DAPy nucleobase) were prepared through a convergent synthesis by olefin cross-metathesis as the key step. Several acyclic nucleoside 4-(2,4-diaminopyrimidin-6-yl)oxy-but-2-enyl]phosphonic acid prodrug exhibited in vitro antiviral activity in submicromolar or nanomolar range against varicella zoster virus (VZV), human cytomegalovirus (HCMV), human herpes virus type 1 (HSV-1) and type 2 (HSV-2), and vaccinia virus (VV), with good selective index (SI). Among them, the analogue 9c (LAVR-289) proved markedly inhibitory against VZV wild-type (TK+) (EC50 0.0035 µM, SI 740) and for thymidine kinase VZV deficient strains (EC50 0.018 µM, SI 145), with a low morphological toxicity in cell culture at 100 µM and acceptable cytostatic activity resulting in excellent selectivity. Compound 9c exhibited antiviral activity against HCMV (EC50 0.021 µM) and VV (EC50 0.050 µM), as well as against HSV-1 (TK-) (EC50 0.0085 µM). Finally, LAVR-289 (9c) deserves further (pre)clinical investigations as a potent candidate broad-spectrum anti-herpesvirus drug.
Asunto(s)
Antivirales , Virus ADN , Pruebas de Sensibilidad Microbiana , Profármacos , Antivirales/farmacología , Antivirales/síntesis química , Antivirales/química , Profármacos/farmacología , Profármacos/síntesis química , Profármacos/química , Humanos , Virus ADN/efectos de los fármacos , Relación Estructura-Actividad , Herpesvirus Humano 1/efectos de los fármacos , Estructura Molecular , Herpesvirus Humano 3/efectos de los fármacos , Organofosfonatos/farmacología , Organofosfonatos/química , Organofosfonatos/síntesis química , Citomegalovirus/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Virus Vaccinia/efectos de los fármacos , Herpesvirus Humano 2/efectos de los fármacosRESUMEN
ß-Aminophosphonates obtained by the Michael addition of primary amines to the double bond of diethyl vinylphosphonate proved to be suitable starting materials (amine components) in the Kabachnik-Fields reaction with formaldehyde and dialkyl phosphites or secondary phosphine oxides to afford N-phosphonylmethyl- and N-phosphinoylmethyl-ß-aminophosphonates. On the other hand, the starting aminophosphonates were modified by N-acylation using acid chlorides. The N-acyl products were found to exist in a dynamic equilibrium of two conformers as suggested by the broad NMR signals. At 26 °C, there may be rotation around the N-C axis of the acylamide function. At the same time, low-temperature NMR measurements at -5 °C revealed the presence of two distinct rotamers that could be characterized by 31P, 13C and 1H NMR data. The modified ß-aminophosphonic derivatives were subjected to a comparative structure-activity analysis on MDA-MB-231, PC-3, A431 and Ebc-1 tumor cell lines, and in a few cases, significant activity was detected.
Asunto(s)
Antineoplásicos , Organofosfonatos , Organofosfonatos/química , Organofosfonatos/farmacología , Organofosfonatos/síntesis química , Humanos , Línea Celular Tumoral , Antineoplásicos/farmacología , Antineoplásicos/química , Antineoplásicos/síntesis química , Relación Estructura-Actividad , Ensayos de Selección de Medicamentos Antitumorales , Estructura Molecular , Proliferación Celular/efectos de los fármacos , Aminas/química , Aminas/farmacología , Aminas/síntesis químicaRESUMEN
Dialkyl/aryl aminophosphonates, 3a-g and 4a-e were synthesized using the LiClO4 catalyzed Kabachnic Fields-type reaction straightforwardly and efficiently. The synthesized phosphonates structures were characterized using elemental analyses, FT-IR, 1H NMR, 13C NMR, and MS spectroscopy. The new compounds were subjected to in-silico molecular docking simulations to evaluate their potential inhibition against Influenza A Neuraminidase and RNA-dependent RNA polymerase of human coronavirus 229E. Subsequently, the compounds were further tested in vitro using a cytopathic inhibition assay to assess their antiviral activity against both human Influenza (H1N1) and human coronavirus (HCoV-229E). Diphenyl ((2-(5-cyano-6-oxo-4-phenyl-1,6-dihydropyrimidin-2-yl) hydrazinyl) (furan-2-yl) methyl) phosphonate (3f) and diethyl ((2-(5-cyano-6-oxo-4-phenyl-1,6-dihydropyrimidin-2-yl) hydrazinyl) (1,5-dimethyl-3-oxo-2-phenyl-2,3-dihydro-1H-pyrazol-4-yl) methyl) phosphonate (4e) were demonstrated direct inhibition activity against Influenza A Neuraminidase and RNA-dependent RNA polymerase. This was supported by their highly favorable binding energies in-silico, with top-ranked values of -12.5 kcal/mol and -14.2 kcal/mol for compound (3f), and -13.5 kcal/mol and -9.89 kcal/mol for compound (4e). Moreover, they also displayed notable antiviral efficacy in vitro against both viruses. These compounds demonstrated significant antiviral activity, as evidenced by selectivity indices (SI) of 101.7 and 51.8, respectively against H1N1, and 24.5 and 5.1 against HCoV-229E, respectively.
Asunto(s)
Antivirales , Coronavirus Humano 229E , Diseño de Fármacos , Subtipo H1N1 del Virus de la Influenza A , Simulación del Acoplamiento Molecular , Organofosfonatos , Pirimidinonas , Antivirales/farmacología , Antivirales/síntesis química , Antivirales/química , Subtipo H1N1 del Virus de la Influenza A/efectos de los fármacos , Humanos , Pirimidinonas/farmacología , Pirimidinonas/síntesis química , Pirimidinonas/química , Relación Estructura-Actividad , Organofosfonatos/farmacología , Organofosfonatos/química , Organofosfonatos/síntesis química , Coronavirus Humano 229E/efectos de los fármacos , Estructura Molecular , Relación Dosis-Respuesta a Droga , Pruebas de Sensibilidad Microbiana , Neuraminidasa/antagonistas & inhibidores , Neuraminidasa/metabolismo , ARN Polimerasa Dependiente del ARN/antagonistas & inhibidores , ARN Polimerasa Dependiente del ARN/metabolismoRESUMEN
A novel series of sulfonamide-incorporated bis(α-aminophosphonates) acting as effective carbonic anhydrase (CA, EC 4.2.1.1) inhibitors is reported. The synthesized bivalent ligands were tested against five human (h) isoforms, hCA I, hCA II, hCA VII, hCA IX, and hCA XIII. Such derivatives showed high activity and selectivity against the cancer-related, membrane-bound isoform hCA IX, and among them, compound 5h, tetraisopropyl (1,3-phenylenebis{[(4-sulfamoylphenyl)amino]methylene})bis(phosphonate) showed a KI of 15.1 nM, being highly selective against this isoform over all other investigated ones (hCA I/IX = 42; hCA II/IX = 6, hCA VII/IX = 3, hCA XIII/IX = 5). Therefore, compound 5h could be a potential lead for the development of selective anticancer agents. The newly developed sulfonamides were also found effective inhibitors against the cytosolic hCA XIII isoform. Compound 5i displayed the best inhibition against this isoform with a KI of 17.2 nM, equal to that of the well-known inhibitor acetazolamide (AAZ), but significantly more selective over all other tested isoforms (hCA I/XIII = 239; hCA II/XIII = 23, hCA VII/XIII = 2, hCA IX/XIII = 3) compared to AAZ.
Asunto(s)
Inhibidores de Anhidrasa Carbónica , Anhidrasas Carbónicas , Diseño de Fármacos , Sulfonamidas , Inhibidores de Anhidrasa Carbónica/farmacología , Inhibidores de Anhidrasa Carbónica/síntesis química , Inhibidores de Anhidrasa Carbónica/química , Humanos , Sulfonamidas/farmacología , Sulfonamidas/química , Sulfonamidas/síntesis química , Relación Estructura-Actividad , Anhidrasas Carbónicas/metabolismo , Cristalografía por Rayos X , Estructura Molecular , Isoenzimas/antagonistas & inhibidores , Antineoplásicos/farmacología , Antineoplásicos/síntesis química , Antineoplásicos/química , Organofosfonatos/farmacología , Organofosfonatos/química , Organofosfonatos/síntesis química , Relación Dosis-Respuesta a DrogaRESUMEN
Root exudates play a key role in the life cycle of Verticillium dahliae, the causal agent of Verticillium wilt diseases, because they induce microsclerotia germination to initiate plant infection through the roots. In olive plants, the genotype and the application of biological control agents (BCAs) or phosphonate salts influence the ability of root exudates to decrease V. dahliae viability. Understanding the chemical composition of root exudates could provide new insights into the mechanisms of olive plant defense against V. dahliae. Therefore, the main goal of this study was to analyze the metabolomic profiles of root exudates collected from the olive cultivars Arbequina, Frantoio, and Picual subjected to treatment with BCAs (Aureobasidium pullulans AP08, Bacillus amyloliquefaciens PAB-024) or phosphonate salts (copper phosphite, potassium phosphite). These treatments were selected due to their effectiveness as inducers of resistance against Verticillium wilt in olive plants. Our metabolomic analysis revealed that the olive cultivars exhibited differences in root exudates, which could be related to the different degrees of susceptibility to V. dahliae. The composition of root exudates also changed with the application of BCAs or phosphonate fertilizer, highlighting the complex and dynamic nature of the interactions between olive cultivars and treatments preventing V. dahliae infections. Thus, the identification of genotype-specific metabolic changes and specific metabolites induced by these treatments emphasizes the potential of resistance inducers for enhancing plant defense and promoting the growth of beneficial microorganisms.
Asunto(s)
Olea , Enfermedades de las Plantas , Raíces de Plantas , Olea/microbiología , Enfermedades de las Plantas/microbiología , Enfermedades de las Plantas/inmunología , Enfermedades de las Plantas/prevención & control , Raíces de Plantas/microbiología , Exudados de Plantas/química , Exudados de Plantas/farmacología , Ascomicetos/fisiología , Metaboloma , Organofosfonatos/farmacología , Metabolómica , Resistencia a la Enfermedad , VerticilliumRESUMEN
Adenovirus infections of immunocompromised humans are a significant source of morbidity and mortality. Presently, there is no drug specifically approved for the treatment of adenovirus infections by the FDA. The state-of-the-art treatment of such infections is the off-label use of cidofovir, an acyclic nucleotide phosphonate. While cidofovir inhibits adenovirus replication, it has dose-limiting kidney toxicity. There is an apparent need for a better compound to treat adenovirus infections. To this end, we have been developing acyclic nucleotide phosphonate prodrugs that utilize an amino acid scaffold equipped with a lipophilic modifier. Here, we compare the antiviral potential of two prodrugs of HPMPA that differ only in the amino acid-based promoiety: USC-087, based on an N-hexadecyl tyrosinamide, and USC-093, based on an N-hexadecyl serinamide. Oral administration of both compounds was very efficacious against disseminated HAdV-C6 infection in immunosuppressed Syrian hamsters, suppressing virus replication and mitigating pathology even when treatment was withheld until 4 days after challenge. We saw only marginal efficacy after respiratory infection of hamsters, which may reflect suboptimal distribution to the lung. Importantly, neither compound induced intestinal toxicity, which was observed as the major adverse effect in clinical trials of brincidofovir, a prodrug of cidofovir which also contains a C-16 modifier. Notably, we found that there was a significant difference in the nephrotoxicity of the two compounds: USC-087 caused significant kidney toxicity while USC-093 did not, at effective doses. These findings will be valuable guidepoints in the future evolution of this new class of potential prodrugs to treat adenovirus infections.
Asunto(s)
Adenina/análogos & derivados , Infecciones por Adenoviridae , Infecciones por Adenovirus Humanos , Organofosfonatos , Profármacos , Tirosina/análogos & derivados , Cricetinae , Animales , Humanos , Infecciones por Adenovirus Humanos/tratamiento farmacológico , Cidofovir/farmacología , Cidofovir/uso terapéutico , Mesocricetus , Antivirales/uso terapéutico , Profármacos/farmacología , Profármacos/uso terapéutico , Adenoviridae , Replicación Viral , Organofosfonatos/farmacología , Organofosfonatos/uso terapéutico , Infecciones por Adenoviridae/tratamiento farmacológico , Citosina/farmacología , Citosina/uso terapéutico , Aminoácidos/farmacología , Nucleótidos/uso terapéuticoRESUMEN
The introduction of antiretroviral therapy in Trinidad and Tobago in the 1980s has resulted in a decrease in mortality of HIV-infected persons. Poor adherence to antiretroviral therapy (ART) has resulted in the development of multidrug resistant HIV. Resistance testing done on 40 samples showed that 64.8% of patients had K103 mutation, 75.6% of patients had M184 mutations and 62% of patients showed resistance to tenofovir suggesting that the K65R mutation was highly likely to be present. There was reduced activity to the protease inhibitors; no resistance was found to the protease inhibitor, darunavir. Thus, there is a need for salvage therapy to be introduced which will result in virologic suppression and potentially stop the spread of multidrug resistant HIV. Darunavir, a new generation protease inhibitor, is an essential part of salvage therapy and needs to be introduced into the national formulary.
La introducción de la terapia antiretroviral en Trinidad y Tobago en la década de 1980, ha producido una disminución en la mortalidad de personas infectadas por el VIH. La adhesión pobre a la terapia antiretroviral (TAR) ha conducido al desarrollo de una variedad de VIH resistente a las multidrogas. Las pruebas de resistencia realizadas a 40 muestras mostró que el 64.8% de los pacientes tenían mutación K103, 75.6% de los pacientes tenían mutaciones M184, y 62% de pacientes mostraron resistencia al tenofovir, lo que indica una alta probabilidad de mutación K65R. Había actividad reducida respecto a los inhibidores de la proteasa; mientras que no se halló ninguna resistencia en el inhibidor de la protease, darunavir. Así, hay necesidad de introducir una terapia de salvamento qué produzca una supresión virológica y potencialmente detenga la diseminación del VIH resistente a las multidrogas. El darunavir - inhibidor de nueva generación frente a la proteasa -es una parte fundamental de la terapia de salvamento y necesita ser introducido en el formulario nacional.